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A Portfolio of Academic, Therapeutic Practice, and Research Work Including a Discourse Analytic Study of how People Self-Positioned as Having Obsessive Compulsive Disorder Construct Agency and Responsibility in Two Online Fora.

Tsiugaras, Nikolaos. (2012) A Portfolio of Academic, Therapeutic Practice, and Research Work Including a Discourse Analytic Study of how People Self-Positioned as Having Obsessive Compulsive Disorder Construct Agency and Responsibility in Two Online Fora. Doctoral thesis, University of Surrey (United Kingdom)..

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Abstract

Background and Aim: Obsessive compulsive disorder (OCD) is a disabling psychiatric condition. It is characterised by anomalous subjective experience that is seen by sufferers as incongruent with their existing self-narrative and treated as unwanted and irrational; sufferers report being unable to discount its validity and attempt to neutralise it with often elaborate rituals. Current medically based treatments of OCD such as cognitive behavioural therapy report partial successes. In this study the validity of a sole reliance on a medical ontology is questioned and social constructionist approach to understanding OCD is advanced. The ways that people self-positioned as suffering from OCD construct accounts of agency and responsibility are examined within two online support forums. Method: Two internet fora were used as sources and the data were analysed using a multi-level discourse analysis. Results: A number of discursive practices around agency and responsibility were discerned. Internet posters abnormalized subjective experience which allowed them to problematize its emergence. Agency for the production of problematic aspects of subjectivity was attributed to OCD as an external entity or to aspects of subjectivity that are constructed as external to the speaker’s agentic self. These practices worked towards disowning this subjective experience and renouncing responsibility for its negotiation. Internet posters contested consequences for action arising from the problematic experience by orienting to dilemmatic binaries around which experiences could be legitimately termed as the product of OCD and therefore ‘not real’. The use of a medical discourse permitted and solidified these practices which were reproduced by support seekers and respondents. A longer extract is presented which demonstrates how a support seeker both appeared to request and consistently discount reassurance about the ‘reality’ of his experience. Conclusion: These strategies reduce responsibility, but also minimize agency and opportunities for resolution of dilemmas. The discursive constructions consistently lead to circular conversations and linguistic dead ends. It appears that these strategies. 119 largely influenced by a medical discourse, offer some stability, but appear inadequate to resolve sufferers’ distress. The implications for psychotherapy are examined.

Item Type: Thesis (Doctoral)
Divisions : Theses
Authors : Tsiugaras, Nikolaos.
Date : 2012
Additional Information : Thesis (Psych.D.)--University of Surrey (United Kingdom), 2012.
Depositing User : EPrints Services
Date Deposited : 14 May 2020 14:56
Last Modified : 14 May 2020 15:02
URI: http://epubs.surrey.ac.uk/id/eprint/856722

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